RT Journal
A1 Green SM, Mason KP
T1 REformulation of the sedation continuum
JF JAMA
JO JAMA
YR 2010
FD March 3
VO 303
IS 9
SP 876
OP 877
DO 10.1001/jama.2010.217
UL http://dx.doi.org/10.1001/jama.2010.217
AB 
A quarter century ago, the concept of sedation as a continuum represented by progressive stages was first introduced.1- 2 These levels of sedation depth were defined by the patient's response to verbal or tactile (light or painful) stimulation. In 1985 this new sedation continuum nomenclature was revolutionary. Pulse oximetry had not yet been introduced, and physiological monitoring was limited to electrocardiogram and blood pressure. Without an objective way to assess ventilatory quality, the authors of the sedation continuum were forced to select subjective “responsiveness” as a surrogate marker to predict the risk of respiratory depression.1- 2 With minor modification, their original definitions have been codified by the Joint Commission into the 4 progressive depths of minimal, moderate, and deep sedation followed by general anesthesia, levels between which patients can fluctuate.3